The Trickery of Remission


Warning: Content has potential triggers. Reader discretion is advised.

I had come to terms awhile ago that Bipolar Disorder is a lifelong disorder. There is no cure. There is treatment. An abundance of treatment.

It was disheartening. It was a huge, ever-looming, oppressive idea. I’m going to go through this for my entire life. Not just a portion, for instance, the rest of my adult life. No. This, this bipolar disorder has been a companion for longer than I can remember. In fact, I could even conclude that it was the very fire of Bipolar Disorder that gave me life in the first place. Born out of this fire and ice.

Not a cure.

When I first started taking Vitamin L, I researched it.  And emblazoned at the top of the Lamictal website is the following statement: Prescription LAMICTAL is used for the long-term treatment of Bipolar I Disorder to lengthen the time between mood episodes in people 18 years or older who have been treated for mood episodes with other medicine.

Lengthen.  Not stop.

How long is that?  A few days?  Maybe a couple of weeks?

Another resignation.  I pitched any hope that there would be any long-term stability for me.  I resigned myself to the idea that I would always be in some state, whether I was slipping down to reside at the bottom of the abyss, streaking through the sky.  It didn’t seem as though there was another option.  Things are the way they are sometimes.  It’s up to us to come to terms with that.

I had decided that there was no such thing as remission in mental health disorders.  For some, it was either dormant or active.  For me, with Bipolar Disorder, there were three states: Depressive, Stable, and Hypomanic, none of which are permanent.  It is just the nature of the disorder.  Hardly anything can have any permanency with ever shifting landscapes.

At the end of October, something incredible happened.  I was not in a state of any kind.  It was like standing between heaven and hell.  Limbo, waiting for the other shoe to drop.  I was convinced that the great plunge was coming, but I only floated down easily from the mother of all hypomanic episodes.  I planted my feet firmly on solid ground, perhaps for the first time in my life.

Initially, I didn’t roam freely around this strange terrain.  There had to be a sinkhole, a bed of quicksand, something, disguised in this lovely place.  About a month of living in this landscape, with the help of others, I started to believe that there was a possibility for full remission.  I was cynical at first.  I had no evidence in my own experience to back up this notion.  However, I began to idealize a wonderful life without living in the constant fear and ever present shadow of Bipolar Disorder.

Idealization is dangerous, and it is something I often fall victim to.  I am not sure if it is a part of the human condition, as much as it is just a characteristic of certain people or disorders.  It remains to be one of the most perilous mechanisms of my delicate mind.  Typically, I knowingly guard myself against this with great cynicism unless I am proven otherwise.  Defy me.

When idealizations occur for me, it is akin to a shattering mirror when realities emerge.  In this instance, it was as if I had come to the ledge, holding tight and gazing deeply into that mirror reflecting my stable illusions.  Distracted by the beauty of it all, I took one false step.  All it takes is one to shatter the illusion, and wake up in the murky depths of depression.

Prior to this run of stability, I had no frame of reference.  A great many people mourn the loss of their lives that occurred prior to the onset of symptoms.  There was no such frame of reference for me.  My diagnosis was a relief.  It provided explanations as to why I was different, and no matter how hard I tried, I couldn’t seem to function properly in any capacity.  I was always content with the diagnosis itself, even if I was affected by the disorder itself.  It gave a name to many of the awful things I had started to believe were just me.

I’m not sure which is worse.  Suffering the constant bombardment of symptoms with little reprieve, or mourning that loss of a blissful, stable state and life I had, but slipped away.

This post brought to you by Tallulah, my Blackberry Bold.

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22 thoughts on “The Trickery of Remission

  1. yeah, I think coming into this group and starting this blog, I was at the tail end of a delusion that my illness had been virtually wiped clean,I know God was with me but I asumed that God had cleared it all away. While it slowly started coming back, I stayed in denial as long as I could. Now I seem to be longing to get back into that old Bipolar routine.

    • You know, in that short stable state I had, I really had a hard time adjusting to it. We learn to live our lives a certain way to accommodate symptoms and episodes. At first, I actually refused to be a stable state. It was just a lull, the short reprieve I would occasionally have. After a month passed, well, you know.

      So, now I’m adjusting back again. That is the part that makes all of this maybe one of my most difficult depressions to handle (but not the worst I’ve ever had).

  2. I hate the dreaded “never can be cured” reminders. It takes away any and all control it seems we need as humans. With heart disease or type 2 diabetes, at least you can try diet changes and exercise to reverse the problem. But not Bipolar. We are absolutely stuck. I guess what we need to come to terms with is that it is a life and death disorder. It is not to be taken lightly.
    I hope you find peace, that we all do. ♥

    • My doctor likened it to heart disease and type 2 diabetes, actually! “With certain genetics, there’s only so much you can do.” He’s right. I got the bum genetics from my family that are going to land me with heart disease and type 2 diabetes long before I should even worry about getting them. I’m already worried.

      But, like those things, there are episodes. Some days, my father just feels bad. Some days my grandmother’s sugar is all over the place. And just like those things, there are things we can do to ease the symptoms.

      Bipolar Disorder isn’t as bad as the ones that severely cut life expectancy, MS, for example.

      I don’t typically feel bad about that looming reminder. But after being let down, you know, like how a person with diabetes thinks they finally know how to control their sugar, I’m reminded. And it’s painful.

  3. I learn so much from your blog. Yesterday I had to see a doctor because I needed a referral to a therapist. The stress has become to much, and it’s a personal stress and should be easily fixable, but I don’t do anything to help myself except dwell. I never want to undermine any disorder by self-diagnosing, but I think I may be bipolar, or something… something isn’t right. So anyway, I have to see a psychiatrist on Thursday. Bummed about it, but I figure talking to a stranger about everything will help. All in all, your blog is inspirational and informative. Thanks girlie ❤

    • I’m glad I could help. Really. That’s one of the reasons why I’m public.

      I can’t say yes and I can’t say no. But, I can say this. You know yourself better than anyone else in the world. If you feel like something isn’t right, then you did yourself a service by seeing a doc.

      Just that step alone, recognizing there is something off, is difficult. Next, is admitting it, and getting treatment. It’s so difficult that it takes some people years to come around to.

      Separating self and symptom is confusing. For me, it’s still an ongoing process. I have determined that some things are exclusively symptom (ex: aggression), and other things are accentuated by symptom (ex: sensitivity and reactivity).

      I’ve heard wonderful things about what therapy has done for people. It’s just not for me. But, therapy only really works for people who are receptive to it anyway.

      Let me know how the appointment goes. And hang in there! You know you can contact me anytime!

  4. My diagnosis was a relief as well. Suddenly, all of my past relationships, the sad times, the crazy times, the emotions all fit and came into focus. It wasn’t “just me” it was an illness overlaying my life. I still blame myself, often when I shouldn’t, and sometimes I blame the illness when I should be taking responsibility for something. But overall, the diagnosis was helpful and saved my marriage in the long run.

    • I know my diagnosis saved my marriage. I had a pattern of self-sabatoge. My husband is really getting better. I was particularly bent out of shape yesterday (again, anger is something I cling to in depression. It’s the healthiest thing I can do in terms of keeping my head above water.) I was going on about something, and he stopped me. “Why are you so upset about this?” I couldn’t find a reason. There wasn’t one. I sighed and said, “There isn’t a reason. I’m not upset about this. I’m just upset and irritable.” He’s gotten a lot better at making me stop and think about things. It helps me, to remind me to slow down when I’m by myself and upset.

      It’s not like I’m not held accountable. Before, when things were turbulent, I know I was held too accountable. I think it’s been accepted that sometimes, I really need derailed rather than be expected to have the ability to stop myself before it even starts happening. It’s the only way to stop the bullet train from careening into bad places.

      It’s nice. Slow down, focus, ask yourself why. If I can’t immediately come up with an answer, then there is no why. There is no problem with that. There’s just a problem with me.

      I have to wonder if this is just a trial and error thing for C.S. He is brilliant, and picks up on things quickly when he opens his mind and focuses. But, I also have to wonder. Is he secretly reading things when I’m not around about how to help?

  5. I really enjoyed the post and it reminded me that sometimes we do experience things or function outside of the boxes that are presented.

    Really good piece.

    Kind Regards,

    Kevin

    • Thank you.

      The piece was me coming to terms once again with the idea that I will never “get better”. Not for good. I will always have to look over my shoulder when I’m stable. I will always have to question if a stable state is real. But, I have to understand that a stable state is not remission. No matter what anyone tells me. This isn’t like cancer, where years of treatment can get rid of it for good. This is more like diabetes, where it needs constant observation. But, the good thing is that bipolar disorder isn’t necessarily fatal, as long-term diabetes usually is in the end.

      • This is my thinking exactly…looking over my shoulder…waiting…I HATE that I have to be on watch. But it’s the only thing that keeps me in recovery…staying disciplined because when I’m not, the scale gets tipped again. Even when I am on watch, sometimes the unforeseen happens and the scale gets tipped even further. It is what it is.

        I’ve determined also that remission isn’t the goal…this will not go away. Recovery is my goal.
        I read this from a psychologist on one of the sites I read some time ago.

        “Recovery, by which they mean management of symptoms, a process of moving beyond the limitations of the disability. Recovery is different from the medical focus on remission, the elimination of symptoms.”

        So I continue to be in recovery. Doing my best with the tools I have. Being mindful. Being on watch. Hoping that medical science or the study of neuro-chemicals, brain activity, etc will continue to shed new light.

        • Recovery is a term I can agree with. Recovery implies that there will be relapse. I am a recovering alcoholic. I don’t count every time I drink as a relapse, for drinking within set parameters is part of our culture. Just like certain emotions within certain parameters are well within the scope of typical. People are programmed to have extreme emotional reactions, just in light of certain circumstances.

          But, in order to avoid fringing on the idea that I will find a place that has long-term stability, I will call myself “in treatment” and as having a “stable state”, if I ever find myself there again.

          To be perfectly fair, some people can probably claim “remission”. Some can find that right mix of meds and other treatments to keep the episodes at bay, or at least so shallow that it’s hardly noticeable. I won’t fool myself. I know, in my bones, I will not likely see that place in my life.

          And surprisingly, I’m okay with that. It sounds pessimistic, but let’s be honest with each other, and more importantly, ourselves. How many people really end up in true remission, years without an episode?

          I have always been this way. And there are just certain things medicine cannot cure.

  6. This is something I worry about. I’m relatively newly diagnosed and fairly stable with treatment, and I am just utterly terrified of losing that. It’s been amazing to feel like I’m no longer completely out of control. I know it won’t necessarily stay this way but I want it to so badly that the disappointment at each mood “blip” is almost worse than the emotional discomfort that caused it.

    I guess I’ll eventually get used to it, but for right now I’m sort of pretending to myself that the relatively calm state of affairs is the way it will stay. The idea that it’ll all be upset at some unknown point in time (which will doubtless be incredibly inconvenient) is too stressful to contemplate.

    • Don’t take this as the final word. There is proof that remission exists in studies for a certain percent of the population. I am just painfully aware that I am not, and cannot be among them.

      But, I wrote this for the very purpose that you explained. The fear of losing that stability. I have always been a person with pretty rapid cycles, especially as it is defined in the DSM-IV. It changes by months, sometimes by weeks. And like I wrote, I’ve read many accounts of people mourning their life prior to the onset.

      I didn’t have any of that. No remnants of a life before BP. No long-term stability. I was always someone who lived within cycles, some so close that they seemed almost overlapping. In the sense that there was no reprieve between. Hypomania and the swan dive from great heights into the ocean of depression.

      To have a moment of stability, a memorable time out of the shackles, was to have the greatest and worst time of my life. And as Sylvia Plath put it, it was if someone had released me from the bell jar, and I was breathing for the very first time. Fresh crisp air. I was living in fluid time, sequentially, instead of scrambling for pieces of fragmented memory or idle in the neverending second.

      But, I am by no means a poster child. If you are stable, live in that stability, but be aware of your red flags. This didn’t entirely take me by surprise. I was ultradian cycling, as seems to be the new norm before I hit a major mood episode. It’s like spinning one of those huge game show wheels. It was almost impossible for me to determine where I was going to land.

      But, I had guessed that it was likely going to be depression, since I hadn’t yet paid the hypomanic piper. No hypomania is a free one, I always try to remind myself. The day will come to pay up sooner or later. Even if I did have hopes that these were blips.

  7. I’m conflicted about diagnoses. My generalized anxiety and social anxiety diagnoses were a relief because they finally validated what I’d been trying to tell my family all my life. They would just shrug and say I’d “get over it” one day. On the other hand, I do have real mental health issues, but there doesn’t seem to be a label that fits it. I have characteristics of several things, yet not enough of any one thing to have a diagnosis (at least one hasn’t been reached at this point). In some ways, it makes me fear that my mental health issues must not be real (even though I know they are). On the other hand, I don’t know if I’d like a diagnosis. I feel that, in a way, a diagnosis might reduce the import of what I have, labeling it as something that others go through, equating it with what others experience. I don’t think it’s like what others go through. Not that it’s anything more. This is hard to explain; I’m not doing a good job of it.

    Your story is interesting to me because it does show, even with diagnoses that equate people, everyone’s experiences with that diagnosis is different. Hmm. Something for me to think about.

    • I agree and think sometimes we are in conflict over diagnoses.

      For years I wanted to ‘know’ exactly what was wrong with me whilst at the same time (and yes I know this sounds silly) hoping that there really wasn’t anything wrong with me and that is was something that I was just ‘imagining’.

      Likewise there is, I think, the fear of ‘labeling’ and the results of labeling. Part of human nature seems to be the tendency in some to search for an appropriate label for something and once found to apply the label to it and then to shelf it. I am a real person with real mental health issues and real needs and I don’t want to be labeled and shelved.

      The other very real concern with labels (and let’s be honest here that is basically what a diagnosis is) is that very often they shape the way people interact with you as very often along with the label come the misunderstandings, misconceptions, stereotypes and stigmas. Yes I might have paranoid schizophrenia but just because your experience or understanding of someone with paranoid schizophrenia is that they stand on the street corner shouting at the traffic it doesn’t mean I am going to. That may well be how that person with paranoid schizophrenia acted and I yes I also have paranoid schizophrenia BUT I am not that person.

      Whilst any label or diagnoses may offer some element of equating people it can’t in my opinion really ever be seen to fully equate people.

      I love to cook, (although admittedly because I live alone I often lack the motivation, enthusiasm or need to really cook very much other than the basic stuff) and I know that I can use the exact self-same recipe 20 times and each time the end result will be slightly different.

      Why? Because the ingredients may have change slightly, slightly fresher or fuller or lesser in flavor, the environment I am cooking in slightly different, or the oven temperature or cooking time slightly different and because I am different each and every time and thus my approach varies.

      Likewise, I will often take a basic recipe and add bits to it or change bits or remove bits to try to develop it and I know that varying the different elements will ultimately vary the result. I think the same is very true of mental health. I have a number of differing mental health issues and diagnoses and they all affect how my mental health presents itself in me.

      I am me and I have my understandings, needs, lifestyle, circumstances. background and experiences and they too influence the way my mental health issues effect me and ultimately present themselves in me. In truth I may share some commonalities in respect of mental health with others but there are a myriad of other influencing factors involved and that makes any equation with others partial at best but never full or complete.

      Hope this helps. It made sense in my head lol

      Kind regards
      Kevin

      • I absolutely helps and is the best summation of this. I love the cooking analogy, by the way. I am partial to baking, and I made a slightly different loaf of bread each time. It used to bother me, not being able to have any kind of uniformity to myself of my life. My best friend in high school was always so put together. Clothes pressed, nails polished, never a single hair out of place. How? How did she do it? Her room was pristine and seemingly geometrically decorated. Everything always looked like it was in it’s right place.

        Why can’t I be so poised and organized? Why can’t I be like her and the rest of those girls? ill fitted clothes, slightly out of style. Frizzy, flyaway wavy hair that did what it pleased, no matter what I did. Mascara smudges under my eyes.

        Because, I’m like the bread. I go in different every day and I come out different too. Baking is not science. The instruments aren’t incredibly precise. Baking times vary.

        It does sometimes still bother me when I stand in front of a mirror and look at myself. My hair isn’t right. My clothes aren’t right. I gained / lost weight. Buttons fell off of something. My clothes are getting noticably worn.

        But, I try to remind myself. I am not exactly the same on the inside every day. I cannot expect myself to be exactly the same on the outside either. And I sure can’t expect myself to be like anybody but me. For better and worse.

      • That’s the idea–not wanting to be shelved. I think that’s what I was trying to get at yet couldn’t explain. I don’t want the diagnoses to be used for people to go “and that’s it–that’s all there is to it.” I also agree with your point about the possibility of others using the label to equate me to someone else.

        • You’re right, that’s not all there is to it. People are extraordinarily complex beings. We are so complex that we have yet to even figure out all of the mysteries of our body and genetics. So, it stands to reason that there is so much more to it than to fit in that little box of diagnoses.

          There’s this whole part of figuring it out for oneself. Taking on the challenge to separate symptom from personality. Because it doesn’t all go into that box. And sometimes, things appear that don’t belong in that box. Have you ever just had a pile of stuff in your house that really didn’t have a designated place? I have a heap. And it ranges from some of my son’s toys, to knickknacks, to art and craft supplies and beyond. That’s how I identify my stuff that just is inexplicable. And it drives me nuts that it’s strewn around.

          But, that’s that. We are who we are, and we should never really have to provide an explanation for ourselves to validate our existence.

    • You’re right about how diagnosis factored into my life. People, namely my family, insisted that “one day I’d grow up and get over it, because it’s just a phase.” I think that was a huge part of why my diagnosis was hard for others to accept. They had been wrong. And they started to question what they did wrong in order to cause this. I know, I’m a mother who has a son with a diagnosis. It’s not easy to hear.

      But, it did validate a lot of things for me. And, it helped me feel less hopeless about myself. People would hand down harsh perceptions, and I would pretend it didn’t affect me. But, truthfully, I’d obsess. And, collecting all of that, carrying it around like an iron anchor, really made me feel like I was the pure essence of those things. And no matter how hard I tried, I’d always be on my way to becoming more so.

      Since I started treatment, I’ve seen things in me that wouldn’t even surface on a good day. Things that had long since been buried by heaps of symptoms and bad memory associated with it. One morning, I woke up, and I realized something. I wasn’t miserable. I didn’t know there could be such a thing, waking up without this intense loathing, feeling forced out of bed and into my life.

      I’ve digressed. That is truth, each individual experiences disorder and dysfunction differently. Why wouldn’t they? Each person has a unique biochemistry. It only makes sense. When it comes to dysfunction, which sets the bar for disorder, everyone feels differently about that. There’s no set point where dysfunction can be determined. (That’s why I despise when people tell me that I have to make lifestyle changes other than diet and exercise. What am I supposed to do? Quit my job, get a divorce, and sign custody of my son over to C.S. No, I don’t think so!)

      As it goes with getting a definitive diagnosis, I’ve always been a firm believer in “the answer is not always the antidote”. It’s just another piece in the puzzle. This is why I have not sought out additional diagnoses. As long as my symptoms are being treated, and they are, then I really don’t care for the label. The only time that might become important is the day they decide to start tweaking my medicine. Because I know that this particular cocktail is treating more than just BP II.

      But more than anything, I was trying to point out that not everyone sees the day where they are symptom free. It’s discouraging as all hell. It might be one of the most grim thoughts I’ve ever had. Why would I possibly keep fighting this if I will never be free of this? Because I’ve already loosened the shackles and lengthened the chain. Yes, I’m still limited in some ways. But, the progress alone is enough. I will do anything to never go back to where I started. I would sell all of my worldly possessions if I had to. I will not give this up, or give in because I may never make it.

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